Andrew Metcalfe, Director of Intelligent Infection Control Services Limited, LumiBio, discusses the benefits of utilising existing technologies to mitigate the ongoing staff shortages in the NHS
Whilst the covid pandemic is by no means over and continues to place stress on the NHS, much is made of staffing shortages (1) with the Health Secretary admitting recruitment plans are not meeting targets.(2)
There are currently almost 94,000 vacancies in the NHS(3) and this fact alone puts pressure on the system with or without a pandemic. This is however, nothing new. Staff shortages have been around this level (or higher) for a number of years and recruitment has been the subject of many a Government statement and is also highlighted within the NHS Long-Term Plan.(4)
Some areas have been very successful in recruiting, such as operating theatre and pharmacy staff,(5) whereas in general the picture is somewhat bleak.
Due to the nature of patient diagnostic/ treatment flow within the NHS, a staff shortage in one area can have a knock-on effect and wide-reaching implications within the system as a whole, causing delays and bottlenecks in treatment and patient throughput. Latest figures show the number of people awaiting treatment in England alone is now 5.72 million, (6) a not inconsiderable amount. The reasons for this are many and varied and not just due to staffing shortages, but shortages are undoubtably a major contributary factor and will also have an impact in how quickly the backlog is cleared. The recruitment issue will not be solved overnight. Ways must be found to allow efficient utilisation of NHS resources to relieve some of the strain on the system. One way to achieve this is to take a holistic approach to care pathways, leveraging new and existing technologies and methods to realise overall streamlining of the patient journey and bring about financial savings and reductions in treatment times. By way of illustration, here is a simple patient scenario showing a total healthcare solution optimised to minimise resource use and thereby free up capacity.
Our patient presents and requires a blood test. Near Patient Diagnostics/ Point Of Care systems such as the Labkit ‘lab in a bag’ (7) can provide quick results and a treatment pathway can be initiated immediately.
Traditionally these systems have been seen as expensive with test costs in the £10-£20 region as opposed to the hypothetical £3.10 NHS cost.(8) This unbundled cost doesn’t take into account the driver/lab/admin costs of a traditional test, nor the extra burden due to delay in treatment associated with standard test turnaround times. Appropriate use of NPD systems frees up lab capacity for the ‘in house’ requirement and improves throughput for other departments, benefitting patients and staff.
Once treatment has commenced, our patient requires hospitalisation. In 2016/17 21% of all bed days across NHS hospitals in England and 79,700 days of absenteeism among front-line Healthcare Professionals were attributed to Healthcare Associated Infections.(9) The financial cost is huge and unfortunately many lives are also lost.(10) Lumibio is an infection prevention and control system that requires no input from healthcare staff.(11)
Providing broad-spectrum protection with no drain on resources and reducing down-time/bed availability, Lumibio can reduce the incidence of infections thereby reducing extra treatment costs, occupancy times and ultimately save lives.
Post-treatment, the patient still requires a low level of care and yet traditionally remains in hospital. This pre-discharge period results in bed days being used for non-urgent care. By implementing a step-down care system which takes advantage of available capacity in other care settings, ‘the flexible estate’, patients can be moved to alternative settings, providing appropriate care at a reduced cost and freeing up bed availability in the initial care facility. This then reduces the bottleneck to allow greater patient throughput and inroads to be made in the patient backlog. Infection is still an ever-present risk in these settings, Lumibio minimises the risk of outbreaks here as well.
Once discharged to home, our patient takes part in Digital Monitoring at Home. Encompassing telehealth, telecare and telemedicine, a digital monitoring system backed up by trained professionals can provide remote monitoring of the recovery period. Any potential adverse occurrence can be swiftly dealt with and should a home call be required, Labkit ‘lab in a bag’ can assist in providing corrective treatment without the need for admission.
So, there is our patient journey, from presentation to recovery, with minimal strain on resources and an active means to reduce readmission.
Whilst not every case is as straight-forward as this, the underlying principles remain. By giving some thought to treatment and care as a whole and being prepared to take on some minimal up-front costs, it is possible to make savings in both money and resources by utilising existing technologies to mitigate the ongoing staff shortages in the NHS. The scenario outlined is simple and achievable and requires nothing more than good communication and joined up thinking. Stepping back, taking the strategic view and ‘boxing clever’ can bring about results that benefit everyone. Solving the recruitment shortage is not so simple, but employing systems such as those described can at least mitigate its impact on the staff and patients of our valiant NHS.
References
(2) https://www.ft.com/content/e7a4ad0e-6fc4-49bc-aaa7-18af75485013
(3) https://files.digital.nhs.uk/12/E72ABB/nhs-vac-stats-apr15-jun21-eng-tables.xlsx
(4) https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
(5) https://www.nuffieldtrust.org.uk/resource/the-nhs-workforce-in-numbers
(7) https://www.england.nhs.uk/2015/03/lab-in-a-bag/
(9) Modelling the annual NHS costs and outcomes attributable to healthcare- associated infections in England. Guest JF, et al. BMJ Open 2020;10:e033367. doi:10.1136/bmjopen-2019-033367 https://bmjopen.bmj.com/content/10/1/e033367
(10) Point prevalence survey of healthcare-associated infections, antimicrobial use and antimicrobial stewardship in England Protocol, 2016. Public Health England https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/773832/PPS_Protocol_for_England.pdf
Please note: This is a commercial profile
© 2019. This work is licensed under CC-BY-NC-ND.
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